Action Points

Note that this study was published as an abstract and presented at a conference. These data and conclusions should be considered to be preliminary until published in a peer-reviewed journal.

Smokers who make it into their 70s still feel the effects of their cigarette habit even after living so long.

Point out that on average, a 70-year-old man who continued to smoke lived 4 years less than a man of similar age who had never smoked, and the quality of his remaining years was diminished.

AMSTERDAM -- Smokers who make it into their 70s are still felled earlier as a result of their cigarette habit, researchers found.

Starting at an average age of 77, men who currently smoked -- versus those who had never smoked -- were more likely to die from any cause over the next 15 years after accounting for age, employment grade, and previous diagnoses of coronary heart disease, stroke, or cancer (88.1% versus 58.6%, relative risk 1.50, 95% CI 1.36-1.64), according to Jonathan Emberson, PhD, of the University of Oxford in England.

On average, a 70-year-old man who continued to smoke lived 4 years less than a man of similar age who had never smoked, and the quality of his remaining years was diminished.

"I think the real message is that risk remains big for smokers at any age," Emberson said at a press briefing. "Quitting remains beneficial at any age."

It has been shown previously that smoking from early in life shaves an estimated 10 years off of a person's life and that quitting can help gain some of that back. Quitting at ages 60, 50, 40, or 30 can recover about 3, 6, 9, 0r 10 years that would have been lost had the person continued to smoke, Emberson said.

But there is less information available about the outcomes of people who survive to older ages and continue to smoke, he said.

To explore the issue, he and his colleagues turned to the original Whitehall Study, which enrolled middle-age, male British civil servants from 1967 to 1970. The participants were surveyed again from 1997 to 1998 when the average age of the respondents was 77.

The current analysis included 7,024 men who responded to the survey and had smoking information available. They were followed for an average of 15 years to the beginning of 2013.

During follow-up, 71% of the men died.

Compared with men who had never smoked, those who were smoking at the time of the re-survey were significantly more likely to die during follow-up of all vascular causes (35% versus 26.2%, RR 1.34, 95% CI 1.16-1.55) and all nonvascular causes (53.1% versus 32.4%, RR 1.62, 95% CI 1.43-1.84). More specifically, smokers were at greater risk of dying from ischemic heart disease, cancer, and respiratory disease.

Emberson noted that those risks accompanied a median intake of nine cigarettes a day.

Ex-smokers fared better, especially if they had quit decades before. The risk of all-cause death during follow-up was not elevated for men who had quit smoking more than 40 years earlier (RR 0.92, 95% CI 0.82-1.03) or 25 to 40 years earlier (RR 1.07, 95% CI 0.97-1.17).

The risk of dying remained higher for those who quit 10 to 25 years earlier (RR 1.22, 95% CI 1.12-1.33) and less than 10 years earlier (RR 1.44, 95% CI 1.30-1.61).

Emberson and his colleagues also found that even if a smoker made it to age 70, he still didn't live as long as someone who had never smoked.

"The significant thing, I think, is to show that you're never home safe as a smoker," commented Eva Prescott, MD, DMSc, of Bispebjerg University Hospital in Copenhagen.

"You might think that if you've survived to the age of 70 then you're resistant to the bad effects of smoking," she told MedPage Today. "But this study clearly shows that when you continue smoking at 70 years you still lose some good years of your life."

"So I think the message is to ... never give up on your patients, keep trying to make them quit smoking even as they reach old age," said Prescott, an ESC spokesperson. "It's never too late to succeed."

The study was funded by the U.K. Medical Research Council, British Heart Foundation, and Cancer Research U.K.

Emberson reported that he had no conflicts of interest.

Reviewed by Robert Jasmer, MD Associate Clinical Professor of Medicine, University of California, San Francisco and Dorothy Caputo, MA, BSN, RN, Nurse Planner

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